Esthetic management of gingival lobular capillary hemangioma: A case report

BACKGROUND: Gingival enlargements may manifest with similar presentations, and their management may be particularly challenging in the esthetic zone when surgical removal leads to residual soft-tissue defects that compromise the function and esthetics. This case report describes the management of a lobular capillary hemangioma (LCH) that required a definitive diagnosis, complete surgical excision, and esthetic reconstruction of the gingival and papillary tissues. METHODS: A 21-year-old woman presented with a progressively enlarging gingival swelling and spacing between the left maxillary anterior teeth. On examination, a soft, nontender, sessile growth was observed, with positive diascopy and palpable pulsations, raising suspicion of a vascular lesion. The lesion was completely excised and submitted for histopathologic examination, which identified it as an LCH. A gingival unit graft (GUG) was simultaneously placed to reconstruct the soft-tissue architecture. RESULTS: The patient healed uneventfully with a satisfactory outcome and soft-tissue graft integration. CONCLUSIONS: The case underscores the need for meticulous treatment planning when managing pathological gingival lesions in the esthetic zone. Immediate soft-tissue reconstruction using a GUG following lesion excision may help restore marginal and papillary gingival architecture and achieve favorable functional and esthetic outcomes. KEY POINTS: Accurate diagnosis of lobular capillary hemangioma requires correlation of clinical findings with histopathologic examination Surgical excision in the esthetic zone should consider the potential loss of marginal and papillary soft tissues Simultaneous gingival unit grafting can help reconstruct gingival and papillary architecture and achieve favorable esthetic outcomes following lesion excision PLAIN LANGUAGE SUMMARY: This report presents the management of a gingival lobular capillary hemangioma associated with prominent vascular clinical features and highlights how careful clinical assessment, definitive histopathologic diagnosis, and immediate soft-tissue reconstruction can facilitate favorable functional and esthetic rehabilitation following lesion excision.